Albion Monitor /Commentary

An excerpt from a dialog by Democratic California Representatives Nancy Pelosi, Lynn Woolsey, and Sam Farr on October 11, 1995.

This Is The Era Of Dickens; We Are Returning To The Past

All this devastation to pay for a tax break for the rich

Ms. PELOSI. Last week the gentleman from California [Mr. Lantos], the gentlewoman from California [Ms. Woolsey], and I held a field hearing in San Francisco on the impact of the extreme Republican proposals to devastate both Medicare and Medicaid, and all this devastation has wrought to pay for a tax break for the rich, yes, a tax break for the rich.

The Republican proposal would cut $270 billion from Medicare and $182 billion from Medicaid programs. Over 50 percent of the tax break will go to the highest 6 percent income earners in the country, over 50 percent of the tax break goes to the highest 6 percent of the population.

The hearing was very revealing. We had an extraordinary list of panelists who are respected in their fields who presented their views on the impact of these drastic cuts.

First, we heard from individuals, experts, really, because they can say directly how these cuts would affect them. The first panel was comprised of representatives of working families, mothers and children and seniors. Our first witness was a pioneer in the field of women's health and women's rights, Del Martin. At age 74, Del was a delegate to the White House Conference on Aging and is a respected community leader.

Del said seniors are more than willing to carry their share of the deficit reduction burden.

We are told that Medicare is responsible for only 6 percent of last year's Federal deficit. Why then, why then is Medicare being cut by 35 percent? That is not fair. Congressional leaders refused to even consider eliminating tax breaks and loopholes which primarily benefit the wealthy. You do not need a PhD in economics to know there is something drastically wrong in this balancing act.

Del went on to say in her testimony the increase in Medicare costs for her personally projected over the Republican plan would amount to over 27 percent of her income, and this percentage would increase as her income diminishes as time goes by. She said as she grows older, that if this Medicare plan is put into effect, her children may have to help her, and that is why these Medicare and Medicaid cuts, these drastic cuts proposed by the extreme Republican majority are of concern to not only our senior citizens but our middle-aged, middle-income families and children in America.

This strikes right to the economic and health security of our senior citizens, but also the economic security of their children

I think it was Betty Davis who said, growing old is not for sissies. And being elderly in our country and being faced with these cuts in Medicare and Medicaid will have a devastating impact on America's families, because if our parents are not cared for, the delivery of service is not paid for by Medicare and Medicaid, then who is going to pay?

Under the Republican plan, I will tell you who is going to pay. The Republicans will have a call on the income of the working children of those elderly parents. The Republican plan will say that a woman, a spouse whose husband has gone, say, to a nursing home under Medicaid will not be able to retain even the $14,000 per year that she is now allowed to save. That money will have to go for her husband's care in the nursing home, and she will be pauperized and not able to stay in the community, and that the Republican plan will allow States to call on the home that that spouse is living in, in order to pay for her husband's care in the nursing home.

So this strikes right to the economic and health security of our senior citizens, but also the economic security of their children as those working married children who are trying to raise their own families will now have more responsibility for the health care bills of their parents.

Another member of the panel was a remarkable young woman, Melica Sadasar, who is director of Family Rights and Dignity, an organization for homeless and low-income families. She spoke to the consequences that changing Medicaid into block grants would have on poor children. She said the decision to block grant Medicaid relegates mothers and children to a caste of disposable human rights. These political decisions simply say that our children, that their lives are not valuable, that their futures are irrelevant.

These changes will not lead to balancing the budget or reducing the deficit

This is political savagery, she had said. This is child abuse masquerading as congressional legislation. 'How can we say to an entire generation of children that their country will not protect or invest in them?'

I contend that these changes in Medicare and Medicaid will not lead to balancing the budget or reducing the deficit. Indeed, the best way for us to do that is to invest in human capital, to invest, to intervene earlier if someone is sick or in need of care, rather than waiting until the bill is so much higher.

Finally, on that panel, Bruce Livingston, the executive director of Health Access, spoke, and he talked very movingly about his parents and what the impact would be on their economics and indeed on their dignity and indeed on his financial security. He said that his father was a Vietnam vet and a career U.S. civil servant, had wisely and carefully structured a health plan for himself and his mother prior to his father's death. That included reliance on Medicare and Medicaid.

Now, like many Americans, his mother must rely solely on herself and whatever benefits she still receives from her husband's pension to make ends meet.

Bruce said, My father worked very hard to provide security for his family. This was the most important thing in his life. When I asked him why he fought in that war, he said, 'I wanted to care for my family.' My father would turn over in his grave if he thought the security he built for my mother was threatened because of proposals for tax cuts for the wealthy.

Bruce's father and mother made their financial decisions based on the promise that Medicare and Medicaid would be there for them. Bruce said, 'My parents kept their promises to the U.S. Government. Now, as their son, I ask you to keep your promise to them.'

As I said earlier, Bruce is part of that sandwich generation where he will now have his assets and his income called upon to help pay for his mother's health care costs.

I saw an interesting poster at one of the rallies that said, 'My children cannot afford my health care.'

It is interesting to hear our colleagues talk about the choices seniors will have

What does it do to the dignity of a senior who has worked all of his or her life to provide for his or her retirement to then have to go to their working-age children, middle-income, working-age children who are caring for their own children, and say, 'We need to call on your assets to take care of my health care benefits because Medicare and Medicaid are no longer there?' It is interesting to hear our colleagues, to talk about the choices seniors will have.

Oh, yes, they will have a choice. They can stay in Medicare with higher premiums and lower benefits. If they go into one of these other managed plans, I predict, you can call that the Roach Motel plan, because once they go in that plan, they are not going to have any choices. It is in and it is not out, and let me choose another plan because I do not like it in there; so seniors have to be very, very concerned about this Republican proposal.

Well, it is clear it is easy to understand why the Republicans want to change Medicare. They did not believe in it in the first place. Ninety-five percent of the Republicans in the Congress voted against Medicare 30 years ago when it was passed in the Congress of the United States. They have not liked it. Now they want to move on from it, and it providing the health security to America's seniors.

We had other panels that I am going to get around to. But first I would like to yield to some of my colleagues from Northern California so that they can address some of the other voices that they are hearing from their districts. They can tell us about some of the other voices they are hearing from their districts on the Republican proposal. I first would like to yield to that fighter for seniors, the gentleman from California [Mr. Farr], who has been in very close touch with the seniors in his district and is here to report on their concerns about the impact of the Republican cuts in Medicare and Medicaid to give a tax break to the 6 percent wealthiest in our country.

This will cost seniors and their families thousands of dollars more for their health care

Mr. FARR of California. I hope that in our brief moment here tonight that we can bring to attention what is really going on in Congress.

Like the gentlewoman, this last week I met with senior citizens in my area and, in fact, they gave me this postcard. They asked me what would I do with it, what does it matter when they go out and gather signatures and then they turn in cards, cards by the hundreds. Every one of these cards is just coming in from the districts daily.

Those cards read:

California seniors are willing to do their fair share to help reduce the budget deficit, but the drastic measures now proposed for Medicaid and Medicare are unacceptable. Your vote, those of Members of Congress, to devastate Medicare in this way would be breaking a campaign promise to thousands of your constituents.

I got to thinking just with that first sentence in there, 'campaign promises.' Is that not what this discussion really is all about? It is not about reforming Medicare. It is about a campaign promise that was made that this year the Republican-controlled Congress will give tax cuts to the very wealthy. That was a promise made, and when you think about it, I looked in the Webster's Dictionary of what is a promise. A promise is a legally binding declaration that gives the person to whom it is made a right to expect or to claim performance or forbearance of a specific act.

In order to deliver on that campaign promise, to cut Federal programs so that they can pay for tax cuts, they have to find a major program like Medicare, and attack it.

Now, we know it has some problems, and we are all willing to do something about it. But if you really want to keep your promises to seniors, you would not be attacking the very program that benefits them. In fact, the first thing you would do is you would get up and say 'Look, this isn't about tax cuts. It is so much not about tax cuts that we are not even going to consider tax cuts. Take them off the table. We'll never deal with them.' That honesty would bring us a long way.

This card goes on to say, 'The current budget proposal described as a reduction in the rate of growth is nothing less than a cut, which will cost seniors and their families thousands of dollars more for their health care.'

Don't break your promise to seniors just because you want to keep your promise to the rich

We just heard a debate that this is not going to cost seniors more, everybody is happy about it. If everybody really believes that, where are they? They are not in here saying 'Give us this Republican proposal, give us this plan. We can't wait to have it. It is going to be so wonderful, the nirvana we are all going to live under when we do not have to spend more with less.'

The card goes on to say, 'Additionally, I am very concerned about congressional plans to cut spending for programs under the Older Americans Act, Meals on Wheels, congruent meal programs, programs to prevent elderly abuse,' all of those programs we heard about at the hearings and out on the lawn that are under the acts. 'Please act responsibly.'

I think that is what we are trying to do here tonight, is be responsible about Medicare, about Medicaid, about the Older Americans Act. These are vital to seniors and to their families.

These cards just come from my district. So when I met with these seniors this last Monday, they said, 'How can we just as individuals out here who have signed our names and have written you cards, and some of us are too old to write long letters, so the best thing we can do is sign a card, how can our plea, our voice, be heard in the U.S. Congress?'

I said, 'There is a wonderful thing about Congress, and that is there are what is called special orders. And I will bring back to the U.S. Capitol, where we are standing tonight, all of these cards and all of this poster that you put out and the signatures you have had, and you will see and the rest of the nation can see your concerns, and will be able to join in with you, as thousands and millions of seniors are doing across the country to say 'don't break your promise to seniors just because you want to keep your promise to the rich.'

Senior citizens who came to a hearing room were ejected from the meeting with the assistance of the police

Ms. PELOSI. As the gentleman says, of course, we all stipulate that we must address the issue of waste, fraud and abuse. Indeed, President Clinton last year in his comprehensive health care reform addressed these issues. This was rejected by the Republicans. The President addressed the issue of the shoring up of the trust fund, of eliminating waste, fraud and abuse, and by moving forward with a comprehensive health plan, universal access to health care for all Americans, really took the bull by the horns in saying this is the only way we are going to address the rising cost of health care in America, is by making health care more available to many more of our citizens.

What is interesting is that today the reason we have the hearings in our district that the gentlewoman from California [Ms. Woolsey] participated in, was because our people really could not come to Washington to be able to be heard by the committees of jurisdiction on this issue. Some came and spoke on the lawn where we had our hearings outside, and some came and spoke in our district. It is very sad that our colleagues on the other side of the aisle were not there to hear what these experts had to say about the Republican proposal, indeed, what the individuals had to say about the insecurity that these proposals brought to their lives.

But what is interesting is what has happened in the last 24 hours here in Washington, DC. Within the last 24 hours, senior citizens who came to a hearing room where Medicare and Medicaid were being written up into legislation, legislative language, were ejected from the meeting with the assistance of the police. These senior citizens were ejected from the meeting. Within a number of hours, representatives of the AMA were waltzed into the Speaker's office to talk about what they wanted out of the Republican Medicare bill. They came out and said 'We picked up, the AMA, we picked up $3 billion. $3 billion. So we support the plan.' Nothing about what this does to undermine the delivery of health care services in America. 'We, the AMA, we picked up $3 billion.'

Well, guess who is paying the $3 billion? Those seniors who got ejected by the police from the hearing, because that same day, as the AMA is celebrating their $3 billion windfall, the Committee on Energy and Commerce voted a $25 per month increase in premiums for senior citizens in America to pay for the increase that they gave the AMA, and to also pay for the tax break, over 50 percent of which goes to the 6 percent highest earners in our country.

They are willing to pay their fair share, but they want fraud and abuse taken care of

Ms. WOOLSEY. First of all, I want to thank you, my fellow Bay Area colleague, for having the forums that we had while we were in the district last week and for putting this special order together tonight, because when I was listening to what they were saying on the other side of the aisle earlier, it totally floored me. We must, in the Bay Area, live in a totally different part of this world or something than they represent, because the entire Bay Area, from Sam Farr's district down to Santa Cruz and north and through San Francisco and into Sonoma County and across the Bay to Oakland, Alameda, and Oakland, we do not hear these things.

I do not know why I did not bring them. I have stacks and stacks of petitions from the people in my district, one of the most affluent districts, by the way, in the United States of America, of seniors saying they do not like these cuts, if not for themselves, for other people they know. They are willing to pay their fair share, but they want fraud and abuse taken care of; they want the tax cuts off the table.

Well, I always do tell people that I am fortunate to represent Marin and Sonoma Counties, because being the two counties directly north of the gentlewoman's district, across the Golden Gate Bridge, I know that all of my fellow members of the Bay Area delegation, including myself and those that I work with in the sixth District, I know that we live in an oasis of sanity. That makes it easier for us, because we work with people who time and time again, our constituents, the true leaders of this country when it comes to caring, when it comes to understanding, and when it comes to working for the rights of other people in this Nation, including their own rights. But they care about other people.

So last week when Nancy and Tom Lantos and I had the hearing in San Francisco and we met with many of the people who wanted to tell us what they thought about these radical cuts in Medicare and Medicaid, which Speaker Gingrich and the new majority are pushing through our Congress, I was comfortable being with all of you, because I knew that we represented districts much the same. But I felt appalled that we had to have these meetings in our districts, which we have been having all over the place anyway.

As a former Member of the Petaluma City Council, we talked longer and harder about sidewalk repairs than Speaker Gingrich and his allies have for this issue

I have had meetings with hospital administrators, with doctors, and with senior citizens throughout my entire district. Nobody is coming to me saying they like what is happening.

But we had to have more meetings than the one in San Francisco, because we are making up for 1 day of hearings here in the House of Representatives in the committee. We tried to make up for that with a week of hearings out on the front lawn, where we could have people come and actually express themselves. But it was important that we take these hearings also to the Bay Area within our own districts.

So when we had our hearings last week, we were able to hear what people really though about the impact of Medicare. The wonderful people spoke out, people like Dr. Tom Peters, who is the head of the Marin County Department of Public Health in my district, and to Anthony Wagner, the executive director of Laguna-Hondo hospital in San Francisco, and Paul Dimoto, who is with the San Francisco AIDS Foundation. They came to us, and they gave us one message to bring back here to Washington. That one message is this: The Gingrich Medicare and Medicaid cuts will devastate the elderly, the poor, and the disabled.

Today, I think we all know that the Committee on Ways and Means passed their assault on Medicare and Medicaid. Today, the new majority demonstrated their willingness to ram their plan through Congress with only 1 day of public hearings. What an outrage.

As a former Member of the Petaluma City Council, I can tell you that we talked longer and harder about sidewalk repairs than Speaker Gingrich and his allies have for an issue which affects the health of millions of Americans.

So we are here tonight, the three of us, speaking out to the people that have been shut out, shut out of the democratic process by the new majority. We are here tonight to tell you that people in the Bay Area, seniors, patients in nursing homes and middle-income families, are scared to death, scared by the new majority's assault on Medicare and Medicaid. They know that this plan will inflict real pain on real people. They know and we know that the Gingrich Medicare and Medicaid plan is not fair. The people of Sonoma and Marin Counties know that the Gingrich Medicare and Medicaid plan is not fair as well as our knowing it.

Maybe even the majority knows that this plan is not fair. Maybe they do not really care. But the American people care, and so do the people who testified before Nancy Pelosi, Tom Lantos, and myself last week in San Francisco. So do the doctors, the hospital administrators, the senior citizens, who have come to forums and hearings that I have had in Marin and Sonoma Counties.

I urge my colleagues, everyone in this House of Representatives, to heed the words of the people that we have been talking to, to reject these attacks on seniors, children, and middle-class families, and to show that we really care, really care about the people in this country.

Every time you tinker with the law, the process requires that the public be aware and know about it -- except in the U.S. Capitol

Ms. PELOSI. It was interesting then and now to hear your point that as a leader in local government, the time that you have spent, the period of public comment that is required for changes in the infrastructure in your district, be it a sidewalk or whatever, and how quickly the Republican majority wants to move forth with its stealth plan before anybody can really see what it is. I know our colleague, Mr. Farr, has a similar experience.

Mr. FARR. I think it is very interesting. The gentlewoman are on a city council and very involved in local government. Congresswoman Pelosi was on the board of supervisors in San Francisco County. I served the local government and then in the State legislature. There is not a city, county, or State in the Nation that does not require publication of any change in law that you are going to make, and that publication has to be available to the public, I know in California, at least 30 days before you even have a public hearing on it.

In the State legislature, an analysis has to be made of both the costs and the benefits, and that is all public information. In fact, you can call up on a hot line and get it, and those bills are free to any constituent in the State of California who wants them.

The point is, every time you are going to tinker with the law, the process requires that the public be aware and know about it. The one exception to that rule is right here in the U.S. Capitol, where essentially you do not have to tell anybody until the day that a vote is taken what is in the law. I think that is very confusing to most of the American public, because they are familiar with going to a school board meeting or going to a city council meeting or even petitioning their State legislature and finding out the details of the law, not what some press release says, not a public relations firm comment, but what is the law. People can read.

In this case, the public of the United States has no idea what is in this great promise to resolve Medicare, other than it is going to affect their pocketbook.

This is the sham being played on America

Mr. FARR. It is essentially going to take money, saying, 'Government, you spend less, and, people, you spend more.' For those people that are on fixed incomes that have signed these petitions that were at your hearing, what did they tell you? 'Our incomes are limited. We are on fixed incomes. We cannot go out and make more money. We do not have the ability to increase our income. Our water bills have gone up, our garbage bills have gone up, our sewage bills have gone up, our telephone bills have gone up, and our cable television bills have gone up. Now you are coming along and saying the most vile thing of all, our health care bills are going to go up even more. Where are we going to get the money to pay for it?'

This is the sham being played on America. It is essentially saying, 'You people, the poorest in the Nation, who have limited incomes, who cannot go out and get more, you have to pay more,' so that they can turn around, take that money, and give tax cuts to the most wealthy people. This is not the Nation of America that takes care of people like that. It is not why we ran for Congress and why we took the oath of office to be here. Not to rob from the poor to give to the rich.

Ms. PELOSI. As the gentleman mentioned earlier, if this is not all about giving a tax break to the wealthiest Americans, why do they not just take the tax cut off the table? Let us address getting rid of waste, fraud, and abuse in Medicare and Medicaid. Let us address the delivery of health care to our senior citizens, because that is mostly what we are talking about here, outside the arena of 'We will take this money and we will spend it on a tax cut.' If that is not what the purpose of this is, let us eliminate it.

Within the Republican Party there are many people saying it is not right to do this; we ought not have that tax cut. But the majority of the Republicans are insisting on it, because that is what this is about. They want to give the tax cut. They are going to where they can get many people who are paying into the system, and that is our seniors, and asking them to pay more into the system for their health care.

It would be a more fair and honest debate if we could have this debate without a tax cut on the table.

The Republicans, in doing what they did with the AMA, told the American voters you do not mean anything to us

Ms. WOOLSEY. I do not believe they are hearing what they are saying they are hearing from their constituents, because their constituents cannot be that different than ours. I know a Republican Representative just north of me. Our newspapers are telling us that his constituents are saying to him what they are saying to me, and that is keep your hands off our Medicare and our Medicaid. Because Medicaid is going to get hit next if we even tweak with Medicare. We will pass it down to the poorest of the poor; our elderly, frail seniors, and also the other third of the people who are on Medicare, which are the disabled and handicapped, and then children who are on welfare, which make up 70 percent of welfare recipients who need Medicaid.

So he is hearing what I am hearing. I know that. They are hearing what we are hearing. They are just trying to tell them that they think something else. It will not work. I do not know about other Members, but I have a lot of faith in the American people, and when they know what is happening to them, they will not put up with this.

Now, when we talk about process and we talk about the difference between local government and State government and county government, we have the Brown Act in California. I cannot imagine taking the AMA into a back room and negotiating what we are going to do with their fees and leaving all of the people, the consumers, the seniors, out of that debate process. No way.

It is such an insult to the people of this country. That is exactly why American voters are getting disenchanted. They think they do not have a say. The Republicans, in doing what they did with the AMA, gave the American voters a lot to believe in when they told them you, the American voters, do not mean anything to us. We are taking a special interest group into a back room and we are going to make great decisions that affect you.

If we are going to do it to people on the domestic side, then we should do it on the defense side or not do it at all

Ms. PELOSI. It is interesting that the gentlewoman makes that comment because at the same time that this is happening, as lobbyists are having very special access in this process, the Republican majority is at the same time saying anyone who gets a grant from the Federal Government should not be able to lobby the Federal Government.

Certainly nobody who gets a grant from the Federal Government should use any of those Federal grant dollars to lobby the Federal Government, and they must use it for the purpose of the grant. But just because an organization has competed in a process and won a grant does not mean they have abdicated their rights as a citizen of our country to be able to petition government. That is the right of a democracy. The public's participation in the formation of public policy is what a democracy is all about as much as a free election of representatives.

So when we talk about process, we are talking about a stealth plan which continues to be substituted.

As recently as 48 hours ago, the plan became a new plan. And as recently as the AMA walking in that office, there was another change made. So we have this stealth plan and then we have a process where there are no open hearings where consumers can come in and citizens can come in and say this is how this would affect me, or professional judgment opinion would say this is how this would affect the delivery of service. And on top of that, we are going to squelch the voices of people who have participated in our process and have won grants.

And yet, when we ask them would they apply that to the Defense Department, which awards contracts into the hundreds of billions of dollars, they say, oh, no, not the Defense Department. Well, if we are going to do it to people on the domestic side, then we should do it on the defense side or not do it at all.

And I prefer that. I prefer that the people who get government contracts have the ability to speak out, whether it is defense contracts or other contracts. But in this situation, the defense contractors are off the table, just as they are in the budget priorities.

A very closed, mysterious system that I think misses a point of honesty

Mr. FARR. I think we are really hitting on what is at stake here. It is really confidence in America. We have lost that confidence. I do not think the Contract for America buys confidence, particularly when you have in that contract this big tax cut. The American public can understand if you want to balance the budget let us stick to balancing the budget, but do not get us confused with also doing big tax cuts.

To the best of my knowledge, frankly, the debate has not been very honest because there are two forms of balancing the budget. There is a fast track, which I think is the Republican form, a steep glidepath, and then there is the more moderate glidepath which the President introduced, and the American public should know what the consequences are by taking either the steep path or by taking the less steep path. Because along the way, if you hurt the most vulnerable people, and we have seen in the Contract With America that we have already hit and hurt rural America, we have hit and hurt the elderly citizens, we have hit and hurt the school children needing lunch programs, we have hit and hurt students who want to go to college by making them pay more. What difference is it going to make if you have a balanced budget if people are too sick to enjoy it, too poor to access college, everything becomes too expensive? You have not really developed this kind of wonderful Utopia that all of a sudden you are going to get with a balanced budget where interest rates come down.

So I think the debate on how you balance the budget ought to be a lot more honest and it should be a lot more honest about who will get hurt if you take the fast slope toward balancing it. And along the way, we are hurting the very people that we want to help.

As you said, we prohibit Girl Scouts from coming in here and lobbying in Congress if they receive any Federal grants, but the big aerospace industry, defense industry, who get billions of dollars, can come in here and lobby for B-2 bombers, even when nobody in the Defense Department wants them, and they are not taken off the list.

So this is really about building confidence in America, and I appreciate both of my colleagues in northern California and the Bay Area for bringing a little sunshine and sunlight into what has been a very closed, mysterious system that I think misses a point of honesty, and the honesty is if we want to balance the budget let us talk about it, but not under the guise of just making poor people pay more so rich people can pay less.

Those who do not agree with what the new majority are not allowed to have their say

Ms. WOOLSEY. In my hearings and forums I have been having in my district, I will have 100 or 200 people possibly in a room, and of course somebody in the room is going to disagree with me, and when that person stands up, the rest of the wonderful senior people as well as this person that stands up and gives his opinion sometimes boo or speak out, and I stop that person, those people immediately and say, no, no, this gentleman has every bit a right to give me his opinion as you do. This is the American process, which is about hearing each other and what we care about.

That has been the disappointment in this debate here in the House of Representatives. We have not allowed those who do not agree with what the new majority is recommending to have their say.

One of the other things they tell me in my meetings is besides taking the tax breaks off the table, why are we increasing the defense budget beyond what the Department of Defense wanted in the first place. They would like those increases off the table, also. They are very clear about that. So those are the kinds of inputs I am getting, and I believe that those around the country, besides ourselves, are getting the same kind of input from their constituents.

Ms. PELOSI. I think the polls are showing that the Republican proposal to cut Medicare in order to fund a tax break for the wealthiest Americans is not a popular proposal in all of America.

I want to take up on a point you mentioned about defense. Certainly we all, as we stipulated earlier, we must address the waste, fraud, and abuse in Medicare, as President Clinton tried to do and as we will all, I think, in a bipartisan way address, and let us also stipulate that we are all patriotic Americans and we want to have a very strong national defense.

But as we try to reduce the deficit and balance the budget, why, when the Republican majority is trying to look for inefficiencies in Government, do they take defense off the table? Maybe there are no inefficiencies in the defense budget. It could be. I doubt it, that there are no inefficiencies in any part of the budget. But why is it not on the table?

So when we say to senior citizens in order to balance the budget in x number of years and give a tax break to the wealthiest Americans, you will have to pay a higher premium per month and that could amount to several hundred dollars a year which, contrary to what my colleagues on the Republican side of the aisle may think, is a great deal of money to our senior citizens, while at the same time we are saying but we will hold harmless the entire defense budget and not look there for any inefficiencies or any ways that we can cut.

So it is about process, it is about the process of a closed process with a stealth plan. It is about substance, it is about what this proposal will do, and it is about priorities. If we do not respect the contributions that have been made by our senior citizens and also recognize that unless we invest in people, as our colleague from California, Mr. Farr, said, what is the use of balancing the budget? Our people are sick, our children are undereducated. If we define a strong country, it certainly is in terms of our national defense and our military might, but it most certainly is even more so in terms of the health, education, and well-being of our people.

They are going to make a choice: Do I help my child go to college or help my parent in a nursing home?

Mr. FARR. I think the big debate here in Congress is how do we ensure that we have a society moving into the 21st century that is a responsible society. It is not just the rights of individuals that you have heard a lot about, particularly when it got into issues about Waco and things like that; it is the responsibilities of society. We are not going to have what I call the domestic tranquility of this country balanced in a style in which we can all appreciate if indeed you have disenfranchised a lot of people. If parents do not think their kids can get an affordable education, we talk about accessible education, accessible education means you can get there from here, that you have a chance to avail yourself of the great schools. And we have some wonderful ones in the State of California, some of the best in the world. But what good are they if they are too expensive to get to and the kids are not getting into because of cost. What good is a health care program if you cannot access it?

So what happens is things, as we know, they get worse. I think that the one difficulty that is not in this entire Contract for America that they are trying to approach is what happens to the people that do not make it, that fall through the cracks.

Ms. PELOSI. That is laissez-faire. Too bad.

Mr. FARR. Do they end up on the streets as the homeless population we are all very familiar with? I think the security of this Nation, the domestic security is dependent on the confidence that people have in government, and a government that tells you that they are going to help you with one hand, balancing the budget, and with the same hand takes away your own ability to access prosperity is a country that is not telling you the truth.

Ms. WOOLSEY. We are missing another point here. That is that this does not just affect seniors. The sandwich generation comes to me in my meetings, 40-, 50-, 60-, and 70-year-olds say to me, I have a parent in a nursing home. The 70-year-olds could be in a nursing home themselves. But they have got parents they are worried about in nursing homes. They know they will have to start taking on more and more of the responsibility for that parent.

Now, many, many of the sandwich generation also have children that need to go to college, and college education is going up. Loans are going to be far more expensive. These same people are going to want to help their children go to college. They are going to make a choice: Do I send my kid to school, help my child go to college; do I help my parent in a nursing home? And for heaven sakes, where will they ever have any discretionary money to put away so that their children do not have to help them when they are seniors? I mean, we are just squeezing the middle income sandwich generation down to having nothing. They are frustrated and, boy, I do not blame them.

This is the era of Dickens; we are returning to the past

Ms. PELOSI. We talked earlier about the middle income, middle-aged people in America, which includes very many people who are the backbone of society, making such a valuable contribution to the greatness of our country, as they try to do their own jobs, educate their children and feel some responsibility for their aging parents, as you call them, the sandwich generation.

They are so at risk not only under the Medicare cuts but under Medicaid cuts. I think many people are not aware, they think of Medicaid as a poor people program. But very many seniors benefit greatly from Medicaid, whether it is long-term health care or, for example, 5 million American women have their Medicare premiums paid by Medicaid, 5 million American women. Of course that is not the whole number. There are men who have it, too. But women would be particularly hit by this.

These Medicaid cuts compound the problems caused by the Medicare cuts. Poor or nearly poor elderly, those are monthly incomes below $625 a month, may no longer be assured that Medicaid will provide cost sharing protections for their Medicare. As I say, the Medicare can pay for their Medicaid, their Medicare premiums, copayments and deductibles. The copays and deductibles can rise and these people, where are they going to get the money to pay for that? From their children.

These low income elderly are doubly hurt because Medicare premiums and copayments will increase substantially at the same time that the Medicaid Program stops paying for them. Further, under the Republican plan, there would be no more guarantee of coverage for nursing home care after an individual or family has spent all of its savings. There would be no more guarantee that spouses of nursing home residents would be able to retain enough monthly income to remain in the community.

States would be allowed to place liens on the family home and family farms. In addition to all of that, States would be allowed to require adult children of nursing home residents to pay for their parents' nursing home care, which could be $40,000 per year. I mean, where are people going to get this money?

If you have a mother or father with Alzheimer's disease, for example, requiring nursing home care and you are trying to put your children through college, you have good reason to oppose the Republican plan. What the Republicans are doing is wrong, and working families deserve better.

I just might add, apart from the money issue, an absolutely shocking part of the proposal is that they would remove the standards from nursing homes. This is the era of Dickens. We are returning to the past. We would eliminate Federal standards for nursing homes. It is appalling.

It is easy to understand why they do not want anybody having public hearings

Ms. WOOLSEY. When I was a youngster, I was in the Girl Scouts. And every Christmas we would sing to nursing homes and go in and out of these nursing homes. This was in the early 1950's. I mean, I am old. I would leave those nursing homes sobbing because here were these old people sitting on newpapers. I had never seen such dismal situations. Well, it is improved now. There is a reason there are national Federal standards for nursing homes. You go in a nursing home and you can pretty much, at least where I live, feel that somebody is being taken care of with quality and dignity.

Well, I just blink and we could go right back to seniors on newspapers.

Ms. PELOSI. It is very hard to understand why they would think that that is a good idea. But it is also easy to understand why they do not want anybody having public hearings to have to come in and testify as to why that is not a good idea.

Mr. FARR. I was just thinking about this issue of national standards. It is too bad that they have not really gone out and asked the American public what they think about it. Obviously we have national standards for aviation. We all use it a lot having to fly back and forth from California. We respect those national standards. They do not leave those up to States. Banks have national standards. The stock exchange has national standards. Drugs have national standards.

I think the American public has realized this in areas where there is a vulnerability at risk, you want some national standards. To say to the most elderly people of this country, your future, your time when you may be most vulnerable in life, most frail in life, we are going to leave this up to your State. If they like you and they have money and they want to spend it on you, they will take care of you.

But what about those States -- and you never know where you are going to end up in life, you do not know where you are going to end up being an elderly person, where in your hometown you may not be able to afford it. Many people move in their elderly age to other States, other locales. Is there not supposed to be some kind of equal playing field here, a common denominator that says in this country that we are going to have standards for people that are in need, that are frail and need special care?

Under this proposal they take them all away. In fact there may not be any standards at all. Is it optional that you do not have to take care of people anymore? What kind of country are we developing here?

We cannot have a country that only marches to the beat of the top 6 percent of the wealthiest

Ms. WOOLSEY. The gentleman said if the State has money, maybe they will have high standards. What about if the consumer or the patient does not have money? I bet you people who have will be in nursing homes that have high standards. Those who are the most vulnerable, who are on Medicaid, who have the least, are probably going to be the ones faced with the nursing homes without standards. And I think that is what we are talking about today.

We are talking about not having a system, that just the few that have plenty get to have, reap the rights. We are talking about having a country where everybody knows that they can have, can live in dignity when they are old and when they are at the end of their lives, that everybody has options for an education. That middle income families do not feel, are not going to feel pulled in the middle, apart, because they do not know whether they should help their parent in a nursing home or their child in a school and they are feeling badly because they are not putting any money away.

We cannot have a country that only marches to the beat of the top 6 percent of the wealthiest in this country, because that is not what this United States is built on.

Ms. PELOSI. Well, I agree. I think that the one thing that everyone in this body will agree to, and that is that we are proud of our country, that it is a great country and that it is a decent country. And I do not think that greatness and decency are associated with what you just described about how our senior citizens, who helped build our country, would be treated under this plan.

Albion Monitor October 30, 1995 (

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